Electrical of Cable-online

The use of antimicrobial agents on the Ministry of Health in 2004 introduced the "antibacterial drug clinical guidelines" in the request, try to do susceptibility testing, the drug of choice varieties based on susceptibility testing. Now, growing clinical susceptibility testing, but the real results of drug susceptibility testing based on limited, and there is obviously unreasonable.
Drug susceptibility results of elections do not look
【Case】 Liu, male, 81 years old, lung infection, gastrointestinal bleeding, hospital stay in the ICU. Blood cultures for Lu baumannii, Klebsiella pneumoniae, antimicrobial susceptibility test results showed that cefoperazone sulbactam against Klebsiella pneumoniae sensitive to resistant Acinetobacter Lu, and amikacin mold Su, etimicin on two types of bacteria are sensitive. But doctors in the choice of drugs, but chose cefoperazone sulbactam.
Analysis】 【sensitivity test before, for severe infection, you can experience medication, but the sensitivity test, the drug of choice should be targeted, and aminoglycoside drugs on two types of bacteria are sensitive to aminoglycoside drugs should be chosen. Older patients, but there is no problem of renal function, and if worried, you can choose a new aminoglycoside antibiotics, such as Etimicin, naphthalene and other stars for the rice should not choose a type of bacteria sensitive only to cefoperazone sulbactam .
Not considered drug contraindications
【Case】 Wie, female, 63 years old, silicosis, pulmonary infection, respiratory medicine in the hospital. Bacterial culture results showed that: Klebsiella pneumoniae infection, drug sensitivity test showed: the bacteria to piperacillin and sulbactam, levofloxacin, imipenem Ding Min him a sense of the West Division. Clinicians selected imipenem cilastatin.
  Medical neglect of imipenem cilastatin medication contraindications, is irrational drug use. The EEG showed diffuse in patients with severe abnormalities, with abnormal central nervous system performance, and imipenem-cilastatin on the central nervous system damage, can lead to insanity, induced epilepsy. Patients with this history, the general should not be optional, you can choose other sensitive drugs.
When a fungus, not select broad-spectrum antibiotics
【Case】 Yang, F, 46 years old, cerebral hemorrhage, moderate head injury, living in neurosurgery. Bacterial culture results were Pseudomonas aeruginosa, Candida albicans, drug susceptibility testing to ceftazidime, ceftriaxone, levofloxacin, amikacin. Doctors chose levofloxacin and fluconazole.
】 【Analysis must take into account, patients fungal infections, including Pseudomonas aeruginosa and Candida albicans. In the treatment, in addition to using antifungal agents, but should choose narrow spectrum antibiotics such as amikacin. Others, such as ceftazidime, ceftriaxone, is broad-spectrum antibiotics, should not be selected.
Joint use of antimicrobial drugs, combined with results to be considered
【Case】 Kim, M, 75 years old, incomplete transection of the right thigh, in the orthopedic patient, severe fever, cough, a serious condition. Pseudomonas aeruginosa blood culture results, drug susceptibility testing to gentamicin, amikacin, cefoperazone, levofloxacin and other sensitive. Doctors have chosen amikacin and levofloxacin, the use of 3 days little effect, the replacement for the amikacin and cefoperazone sulbactam, 3 days after infection control.
Analysis】 【serious condition because patients, is a serious infection, antibiotics should be used in combination. However, in combination with antimicrobial drugs, not just look at the results of susceptibility testing, combined with clinical experience, to see what pathogens, in what parts of the infection. To the patients, single agent, quinolones, and aminoglycosides may play a role, but in the combination therapy, the aminoglycoside and cephalosporin drugs in combination results, better than the United quinolones.
Seen from the above cases, many clinicians have been seriously susceptibility testing, but in the susceptibility test results came out, how to choose the drug-sensitive, pay attention to the use of drug contraindications and adverse reactions, is still a serious problem. Respective topics: drug Daquan
Previous article: Must see: the best time for medication
Next article: What is the role of constipation alternating diarrhea medicine hair